TITLE:
Prognostic Role of Pulse Pressure in the Acute Phase of Myocardial Infarction
AUTHORS:
Justin Koffi, Christoph Konin, Yves N’goran, Arnaud Ekou, Ambroise Gnaba, Esaie Soya, Marie Paul N’Cho Mottoh, Bénédict Boka, Michel Adoh Adoh
KEYWORDS:
Myocardial Infarction Pulsed, Pressure, African
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.5 No.8,
August
28,
2015
ABSTRACT: Objective: Pulse pressure is a cardiovascular risk factor. The aim of our study was to assess the short and medium term prognosis of myocardial infarction in the African black having a high pulse pressure. Methods: We performed a comparative retrospective study of 200 patients hospitalized in the Cardiology Institute of Abidjan. The first group (100 patients) had a high pulse pressure (≥60 mmHg). The second (100 patients) had normal pulse pressure (≤60 mmHg). The primary outcome was mortality. Secondary endpoints were represented by hemodynamic complications, rhythmic and conduction disturbances. Both groups of patients were matched. The matching is performed by socio-demographic criteria, the seat of necrosis and cardiovascular risk factors. The authors explained the choice of 60 mmHg as references because in all their studies they have realized that it is from 60 mmHg pulse pressure morbid events that occur in prospective studies and retrospective studies in stiffness of the great arteries is responsible for all these events. Pulse pressure is in itself, an independent cardiovascular risk factor in systolic blood pressure, diastolic blood pressure when associated with myocardial infarction, it becomes from 60 mmHg poor prognostic factor especially in the acute phase. Results: The mean age was 54.46 ± 10.10 years for patients with normal pulse pressure and 52.32 ± 10.89 years in patients with high pulse pressure. Patients with elevated pulse pressure were twice as left ventricular failure (Chi2 = 3.71; P = 0.048 = 2 OR 95% CI = 0.93 to 4.29). These patients had an ejection fraction and fractional shortening double bass (Chi2 = 31.23 P = 0.00001, OR = 2.2 95% CI 0.8 to 17.4) 10 mmHg for increased pulse pressure we observed an average growth of 18% mortality rate. Mortality was three times higher in patients with elevated pulse pressure (Khi2 = 15, 06 ddl = 1 P = 0.0001 OR = 3.34 95% CI 1.72 to 6.52). Conclusion: The high pulse pressure represented an independent poor prognostic factor in the acute phase of myocardial infarction in the black African.